Physician-assisted suicide: Permission is recipe for abuse

January 30, 2013 8:30 am

In the 2011 legislative session, Sen. Anders Blewett and I introduced competing bills in response to the Montana Supreme Court’s assisted-suicide case, Baxter v. State. The case did not legalize assisted-suicide. Its language was, however, a “toe in the door,” which could lead to legalization in the future.

Neither bill passed. His bill had sought to legalize assisted-suicide; mine had sought to reverse Baxter. This legislative session, there will likely be a similar contest.

The vast majority of states to consider assisted suicide have rejected it. In the past two years, three states have strengthened their laws against assisted suicide: Georgia, Louisiana and Idaho. Only two states allow it, Oregon and Washington. Their laws were enacted by initiative campaigns.

No such law has made it through the scrutiny of a legislature despite more than 100 attempts.

Legal assisted suicide is, regardless, a recipe for elder abuse in which heirs are empowered to pressure and abuse older people to cut short their lives. I urge you to tell your legislators that you support legislation to close on the door on assisted suicide in Montana.

To learn more, see this website: www.choiceillusionmontana.org

Greg Hinkle, Thompson Falls

Physician-assisted suicide runs risk of invisible coercion

http://mtstandard.com/news/opinion/mailbag/physician-assisted-suicide-runs-risk-of-invisible-coercion/article_121a9ba4-681a-11e2-b046-0019bb2963f4.html?print=true&cid=print

Ben Mattlin writes in The New York Times on Oct. 31, 2012, that he counts himself as a pro-choice liberal who ought to support physician-assisted suicide, but as a lifelong disabled person, he cannot.

Physician-assisted suicide is a person swallowing a lethal drug prescribed by a doctor. With plenty of room for abuse, Mattlin says, it’s a bad idea.

In Montana, the issue of physician-assisted suicide has been kicked around in the Legislature and in the courts, including the Montana Supreme Court, resulting in a mixed message that needs clarity. This Legislature will try again.

Here’s Mattlin: “My problem, ultimately, is this: I’ve lived so close to death for so long that I know how thin and porous the border between coercion and free choice is, how easy it is for someone to inadvertently influence you to feel devalued and hopeless — to pressure you ever so slightly but decidedly into being ‘reasonable’ to unburdening others, to ‘letting go.’”

He goes on to say that, while the push for physician-assisted suicide comes from many who have seen a loved one suffer, supporters of it can’t truly conceive of the many “subtle forces — invariably well-meaning, kindhearted, even gentle, yet as persuasive as a tsunami — that emerge when your physical autonomy is hopelessly compromised.”

Mattlin was born with spinal muscular atrophy. He has never walked, stood, or had much use of his hands. Half of babies with this condition die within two years. Today, Mattlin, almost 50, is a husband, father, journalist and author.

When a hospital blunder compromised his heath further, doctors questioned whether his life was worth saving. Mattlin writes, “They didn’t know about my family, my career, my aspirations.” His wife rescued him.

From this he learned how easy it is to be perceived as someone whose quality of life is untenable and how this becomes one of many invisible forces of coercion. Others include, “that certain look of exhaustion in a loved one’s eyes, or the way nurses or friends sigh in your presence while you are zoned out in a hospital bed.”

Mattlin writes that this can cast a dangerous cloud of depression upon even the most cheery of optimists. He says, “advocates of Death with Dignity laws who say that patients themselves should decide whether to live or die are fantasizing. We are inexorably affected by our immediate environment. The deck is stacked.”

Cort Freeman
2950 Bayard St.
Butte

Assisted suicide would exacerbate problem of elder abuse in Montana

http://missoulian.com/news/opinion/mailbag/assisted-suicide-would-exacerbate-problem-of-elder-abuse-in-mt/article_bffd5bbc-68d3-11e2-ae9f-0019bb2963f4.html?print=true&cid=print

For over 20 years, I have been an internal medicine physician with a high percentage of older patients. I have had the painful misfortune of personally observing countless instances of elder abuse.

Elder abuse is horrific and on the rise. Perpetrators of the abuse include hired caregivers, neighbors and family members. In my experience, the motive is usually financial gain. This was true in the case of one of my patients, where a much younger man obtained financial control (became payee for Social Security and retirement benefits) by taking advantage of an elderly woman’s loneliness and dementia. He feigned romantic interest in her, flattering her to the point that she took his side against her family members. She became isolated and totally dependent on him. After many months, Adult Protective Services was able to provide a guardian. This same motive of greed could lead to coerced assisted suicide if there was anticipated financial gain, and death could occur quickly if assisted suicide was legal – before protection could be put in place.

In Oregon and Washington, where assisted suicide is legal, portions of those states’ statutes lend themselves to elder abuse, such as the fact that no witness is required at the time of death. An elderly patient of mine recently died peacefully and of natural causes in his home, surrounded by family. His daughter was devastated when a family member visiting from Oregon asked if they had given him pills to end his life, as they would have done in her state.

Elder abuse is already a huge problem in Montana. I hope Montana’s legislators will have the courage to stop legalization of assisted suicide here and thereby protect the elderly and disabled.

For more information, including a summary of this important issue, see www.montanansagainstassistedsuicide.org.

Annie Bukacek,
Kalispell

Oregon doctor could not save patient from assisted suicide

http://mtstandard.com/news/opinion/mailbag/oregon-doctor-could-not-save-patient-from-assisted-suicide/article_a4b605ba-6767-11e2-bf94-0019bb2963f4.html

I am a doctor in Oregon, where assisted suicide is legal. A few years ago, I was caring for a 76-year-old man who presented to my office a sore on his arm, eventually diagnosed as melanoma. I referred him to specialists for evaluation and therapy.

I had known this patient and his wife for more than a decade. He was an avid hiker, a popular hobby here in Oregon. As his disease progressed, he was less able to do this activity, becoming depressed, which was documented in his chart.

During this time, my patient expressed a wish for assisted suicide to one of the specialists. Rather than take the time to address his depression, or ask me as his primary care physician to talk with him, she called me and asked me to be the “second opinion” for his suicide. She told me that barbiturate overdoses “work very well” for patients like this, and that she had done this many times before.

I told her that assisted suicide was not appropriate for this patient and that I did not concur. I was very concerned about my patient’s mental state, and told her that addressing his underlying issues would be better than simply giving him a lethal prescription. Unfortunately, my concerns were ignored, and two weeks later my depressed patient was dead from an overdose prescribed by this doctor.

Under Oregon’s law, I was not able to protect my depressed patient. If assisted suicide becomes legal in Montana, you may not be able to protect your friends or family members.

I urge you to contact your legislators to tell them to keep assisted suicide out of Montana. Don’t make Oregon’s mistake.

Dr. Charles J. Bentz
Portland, Ore.

Oregon Assisted Suicide Law is Not Safe According to Lawyer

http://mtstandard.com/news/opinion/mailbag/oregon-assisted-suicide-law-is-not-safe-according-to-lawyer/article_329524a6-629a-11e2-bea8-0019bb2963f4.html?print=true&cid=print

I am a lawyer in Oregon who specializes in injury claims including wrongful death cases. I understand that Montana will be considering assisted suicide legislation this session. I write to inform your readers that Oregon’s assisted suicide law lacks transparency. Even law enforcement is denied access to information collected by the State. Moreover, this is official state policy.

In 2010, I was retained by a client whose father had died under our assisted-suicide act. Unlike other deaths I have investigated, it was difficult to get basic information.

After I wrote the state epidemiologist, I received a letter from the Attorney General’s Office that the agency charged with collecting assisted-suicide data, the Oregon Health Authority, “may only make public annual statistical information.” The letter also referred me to the Oregon Medical Board and law enforcement.

The Board wrote me that there could be no investigation without an allegation of misconduct against a physician. At my request, a police officer was assigned to the case. Per his confidential report, the Oregon Health Authority would neither confirm nor deny that my client’s father had died under our act. Per the report, the officer did, however, talk to the doctor signing the death certificate who said that he did not know that the death had involved assisted-suicide. The death certificate listed the immediate cause of death as “cancer” and the manner of death as “natural.”

Per the report, the officer also spoke with potential perpetrators who assured him that the death had been voluntary. He closed the case.

This is a link to Oregon’s data release policy as of Jan. 1, that it “will not confirm on a case-by-case basis whether an individual has used, or a provider has been involved, with Death with Dignity.” http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/policy.aspx

Without transparency our law is not safe.

Isaac Jackson
Box 41240
Eugene, Ore.

“Dr. Stevens, you saved my life!”

http://ravallirepublic.com/news/opinion/mailbag/article_34acbde8-3686-11e2-b260-0019bb2963f4.html?cid=print

I am a doctor in Oregon, one of two states where assisted-suicide is legal. This letter responds to your article about the controversy over this practice in Montana. (AP article, Medical Examiners Board, Nov. 16, 2012). I write to clarify that legalizing assisted suicide would allow non-dying persons to be steered to suicide.

 

Oregon’s assisted-suicide law applies to patients predicted to have less than six months to live. In 2000, I had a cancer patient named Jeanette Hall. Another doctor had given her a terminal diagnosis of six months to a year to live. This was based on her not being treated for cancer.

At our first meeting, Jeanette told me that she did not want to be treated, and that she wanted to opt for what our law allowed – to kill herself with a lethal dose of barbiturates.

I did not and do not believe in assisted suicide. I informed her that her cancer was treatable and that her prospects were good. But she wanted “the pills.” She had made up her mind, but she continued to see me.
On the third or fourth visit, I asked her about her family and learned that she had a son. I asked her how he would feel if she went through with her plan. Shortly after that, she agreed to be treated, and her cancer was cured.

Five years later she saw me in a restaurant and said, “Dr. Stevens, you saved my life!”

For her, the mere presence of legal assisted suicide had steered her to suicide.

I understand that assisted suicide will be an issue in your upcoming legislative session. I urge you to encourage your legislators to clarify your law to keep assisted suicide out of Montana.

Kenneth Stevens, MD
Sherwood, Ore.

Oregon Doctor's Letter to Medical Society

I practice internal medicine in Oregon where assisted suicide is legal.  I write to urge you to maintain your policy against physician-assisted suicide and have attached a copy of this letter to this e-mail.  Contrary to marketing rhetoric by suicide advocates, the safeguards do not protect patients.  Please consider my patient’s story below.

I was caring for a 76 year-old man who presented to my office with a sore on his arm, eventually diagnosed as metastatic malignant melanoma.  I referred him to both medical and radiation oncology for evaluation and therapy. I had known this patient and his wife for over a decade. He was an avid hiker, a popular hobby here in Oregon, and as his disease progressed, he was less able to do this, becoming depressed, which was documented in his chart. My patient expressed a wish for doctor-assisted suicide to the medical oncologist, but rather than take the time to address depression or ask me, as his primary care physician, to talk with him, the specialist called me and asked me to be the "second opinion" for his suicide.  I told her that assisted suicide was not appropriate for this patient, but unfortunately, my concerns were ignored, and two weeks later my depressed patient was dead from an overdose prescribed by this doctor. His death certificate listed the cause of death as melanoma.

"I was afraid to leave my husband alone"

Letter from Oregon resident, Kathryn Judson, Published in the Hawaii Free Press, February 15, 2011.  To view the original letter, click here and scroll down towards the bottom of the page.   

When my husband was seriously ill several years ago, I collapsed in a half-exhausted heap in a chair once I got him into the doctor's office, relieved that we were going to get badly needed help (or so I thought).

To my surprise and horror, during the exam I overheard the doctor giving my husband a sales pitch for assisted suicide. 'Think of what it will spare your wife, we need to think of her' he said, as a clincher.

Now, if the doctor had wanted to say 'I don't see any way I can help you, knowing what I know, and having the skills I have' that would have been one thing. If he'd wanted to opine that certain treatments weren't worth it as far as he could see, that would be one thing. But he was tempting my husband to commit suicide. And that is something different.

I was indignant that the doctor was not only trying to decide what was best for David, but also what was supposedly best for me (without even consulting me, no less).

We got a different doctor, and David lived another five years or so. But after that nightmare in the first doctor's office, and encounters with a 'death with dignity' inclined nurse, I was afraid to leave my husband alone again with doctors and nurses, for fear they'd morph from care providers to enemies, with no one around to stop them.

It's not a good thing, wondering who you can trust in a hospital or clinic. I hope you are spared this in Hawaii.

Kathryn Judson, Oregon

Updated Quick Facts About Assisted Suicide

By Margaret Dore, Esq.*

For a new print version, suitable for a handout, click here.

1.  Assisted Suicide

Assisted suicide means that someone provides the means and/or information for another person to commit suicide.  When a physician is involved, the practice is physician-assisted suicide.[1]

2. The Oregon and Washington Laws

In Oregon, physician-assisted suicide was legalized in 1997 via a ballot measure.[2]  In Washington State, a similar law was passed via another ballot measure in 2008 and went into effect in 2009.[3]  No such law has made it through the scrutiny of a legislature despite more than 100 attempts.[4]

3.  Patients are Not Necessarily Dying

The Oregon and Washington laws are restricted to patients predicted to have less than six months to live.[5]  Such persons are not necessarily dying.  Doctors can be wrong.[6]  Moreover, treatment can lead to recovery.  Consider Jeanette Hall, who was diagnosed with cancer and given six months to a year to live.[7]  She was adamant that she would "do" Oregon’s law, but her doctor, Ken Stevens, convinced her to be treated instead.[8] She is still alive 12 years later.[9]

4.  A Recipe for Elder Abuse

The Washington and Oregon laws are a recipe for elder abuse. The most obvious reason is due to a lack of oversight when the lethal dose is administered.[10] For example, there are no witnesses required at the death; the death is allowed occur in private.[11] With this situation, the opportunity is created for an heir, or some other person who will benefit from the patient’s death, to administer the lethal dose to the patient without his consent.  Even if he struggled, who would know?

5. Empowering the Healthcare System

In Oregon, patients desiring treatment under the Oregon Health Plan have been offered assisted suicide instead. 

The most well known cases involve Barbara Wagner and Randy Stroup.[12] Each wanted treatment.[13] The Plan denied their requests and steered them to suicide by offering to pay for their suicides.[14] Neither Wagner nor Stroup saw this scenario as a celebration of their "choice." Wagner said: "I'm not ready to die."[15] Stroup said: "This is my life they’re playing with."[16]

Wagner and Stroup were steered to suicide. Moreover, it was the Oregon Health Plan, a government entity, doing the steering.[17]

6. Suicide Contagion

Oregon's suicide rate, which excludes suicides under its physician-assisted suicide law, has been "increasing significantly" since 2000.[18] 

Just three years prior, Oregon legalized physician-assisted suicide. This increased suicide rate is consistent with a suicide contagion. In other words, legalizing one type of suicide encouraged other suicides.  Montana already has one of the highest suicide rates in the nation.[19]

7.  A "Wedge" Issue

In Washington State, where assisted suicide was legalized four years ago, there is already a discussion to expand its law to direct euthanasia for non-terminal people.[20]  Indeed, last March, there was a column describing reader suggestions for euthanasia for people unable to afford care, which would be on an involuntary basis for people who want to live.[21]

* Margaret Dore is an attorney in Washington State where assisted suicide is legal.  She is also President of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide.  For more information, see www.margaretdore.com and www.choiceillusion.org 

[1]  Compare: American Medical Association, Code of Medical Ethics, Opinion 2.211, available at http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion2211.page
[2]  The Oregon and Washington laws are similar.  For a short article about Washington’s law, see Margaret K. Dore, "'Death with Dignity': What Do We Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009, available at https://www.kcba.org/newsevents/barbulletin/BView.aspx?Month=05&Year=2009&AID=article5.htm
[3]  Id.
[4]  http://epcdocuments.files.wordpress.com/2011/10/attempts_to_legalize_001.pdf
[5]  See ORS 127.800 s.1.01(12) and RCW 70.245.010(13).
[6]  See e.g., Nina Shapiro, "Terminal Uncertainty: Washington’s new "Death With Dignity" law allows doctors to help people commit suicide—once they’ve determined that the patient has only six months to live. But what if they’re wrong?," 01/14/09, available at http://www.seattleweekly.com/2009-01-14/news/terminal-uncertainty 
[7]  See Jeanette Hall, Letter to the editor, "She pushed for legal right to die, and - thankfully - was rebuffed, Boston Globe, October 4, 2011 ("I am so happy to be alive!), available at http://www.boston.com/bostonglobe/editorial_opinion/letters/articles/2011/10/04/she_pushed_for_legal_right_to_die_and___thankfully___was_rebuffed/ Kenneth Stevens MD, Letter to the Editor, "Oregon mistake costs lives," The Advocate, the official publication of the Idaho State Bar, Sept. 2010, (scroll down to last letter at www.margaretdore.com/info/Stevens.pdf ).
[8]  Id.
[9]  Per her telephone call today.
[10]  The Oregon and Washington Acts can be viewed in their entirety here and here.
[11]  Id.
[12]  See Susan Donaldson James, "Death Drugs Cause Uproar in Oregon," ABC News, August 6, 2008, at http://abcnews.go.com/Health/story?id=5517492&page=1; "Letter noting assisted suicide raises questions," KATU TV, July 30, 2008, at http://www.katu.com/news/specialreports/26119539.html ; and Ken Stevens, MD, Letter to Editor, "Oregon mistake costs lives," The Advocate, the official publication of the Idaho State Bar, September 2011, to view, scroll down to bottom of second page here: http://www.margaretdore.com/info/September_Letters.pdf
[13] Id.
[14] Id.
[15] KATU TV at note 12
[16] ABC News at note 12
[17]  See also Affidavit of Ken Stevens MD (Leblanc v. Canada), with attachments, available at http://maasdocuments.files.wordpress.com/2012/09/signed-stevens-aff-9-18-12.pdf 
[18]  See "Suicides in Oregon: Trends and Risk Factors," Oregon Department of Human Services, Public Health Division, September 2010, page 6, ("Deaths relating to the death with Dignity Act (physician-assisted suicides) are not classified as suicides by Oregon law and therefore excluded from this report"), available at http://epcdocuments.files.wordpress.com/2011/10/or_suicide_report_001.pdf
See also Oregon Health Authority, News Release, "Rising suicide rate in Oregon reaches higher than national average," September 9, 2010, ("suicide rates have been increasing significantly since 2000") available at http://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf[19]  Cindy Uken, "State of Dispair: High-Country Crisis, Montana’s suicide rate leads the nation," Billings Gazetter, November 25, 2012, http://billingsgazette.com/news/state-and-regional/montana/montana-s-suicide-rate-leads-the-nation/article_b7b6f110-3e5c-5425-b7f6-792cc666008d.html?print=true&cid=print
[20]  See Brian Faller, "Perhaps it's time to expand Washington's Death with Dignity Act, The Olympian, November 16, 2011, available at http://www.theolympian.com/2011/11/16/1878667/perhaps-its-time-to-expand-washingtons.html
[21]  See Jerry Large, "Planning for old age at a premium," The Seattle Times, March 8, 2012 at http://seattletimes.nwsource.com/text/2017693023.html ("After Monday's column, some readers were unsympathetic, a few suggested that if you couldn't save enough money to see you through your old age, you shouldn't expect society to bail you out. At least a couple mentioned euthanasia as a solution.")

Assisted Suicide is a Bipartisan Issue

Dear Editor:

I am a former three-term State Representative in New Hampshire who has been following the assisted suicide issue  throughout the United States.  The sentiment expressed by the recent AP article on this issue in Montana is correct, that it can lead to “cross aisle allegiances.” [01/06/13]

In New Hampshire, a bill to legalize assisted suicide was defeated in 2011 in the New Hampshire House, 234 to 99.  A similar bill was defeated in the House in 2010.  The vote was 242 to 113.

These were bi-partisan votes.  In 2010, the House was controlled by the Democrats. In 2011, the House was controlled by the Republicans.  In both years, assisted suicide was defeated by a 2 to 1 margin.

Assisted suicide laws empower heirs and others to pressure and abuse older people to cut short their lives.  This is especially an issue when the older person has money.  There is NO assisted suicide law that you can write to correct this huge problem.

Do not be deceived.

Nancy Elliott

Merrimack, New Hampshire

Quick Facts About Assisted Suicide

By Margaret Dore, Esq.*

For a print version, click here.

1.  Assisted Suicide

Assisted suicide means that someone provides the means and/or information for another person to commit suicide.  When a physician is involved, the practice is physician-assisted suicide.[1]

2. The Oregon and Washington Laws

In Oregon, physician-assisted suicide was legalized in 1997 via a ballot measure.[2]  In Washington State, a similar law was passed via another ballot measure in 2008 and went into effect in 2009.[3]  No such law has made it through the scrutiny of a legislature despite more than 100 attempts.[4]

3.  Patients are Not Necessarily Dying

The Oregon and Washington laws are restricted to patients predicted to have less than six months to live.[5]  Such persons are not necessarily dying.  Doctors can be wrong.[6]  Moreover, treatment can lead to recovery.  Consider Jeanette Hall, who was diagnosed with cancer and given six months to a year to live.[7]  She was adamant that she would "do" Oregon’s law, but her doctor, Ken Stevens, convinced her to be treated instead.[8] She is still alive 12 years later.[9]

4.  A Recipe for Elder Abuse

The Washington and Oregon laws are a recipe for elder abuse. The most obvious reason is due to a lack of oversight when the lethal dose is administered.[10] For example, there are no witnesses required at the death; the death is allowed occur in private.[11] With this situation, the opportunity is created for an heir, or some other person who will benefit from the patient’s death, to administer the lethal dose to the patient without his consent.  Even if he struggled, who would know?

5. Empowering the Healthcare System

In Oregon, patients desiring treatment under the Oregon Health Plan have been offered assisted suicide instead. 

The most well known cases involve Barbara Wagner and Randy Stroup.[12] Each wanted treatment.[13] The Plan denied their requests and steered them to suicide by offering to pay for their suicides.[14] Neither Wagner nor Stroup saw this scenario as a celebration of their "choice." Wagner said: "I'm not ready to die."[15] Stroup said: "This is my life they’re playing with."[16]

Wagner and Stroup were steered to suicide. Moreover, it was the Oregon Health Plan, a government entity, doing the steering.[17]

6. Suicide Contagion

Oregon's suicide rate, which excludes suicides under its physician-assisted suicide law, has been "increasing significantly" since 2000.[18] 

Just three years prior, Oregon legalized physician-assisted suicide. This increased suicide rate is consistent with a suicide contagion. In other words, legalizing one type of suicide encouraged other suicides.  Montana already has one of the highest suicide rates in the nation.[19]

7.  A "Wedge" Issue

In Washington State, where assisted suicide was legalized four years ago, there is already a discussion to expand its law to direct euthanasia for non-terminal people.[20]  Indeed, last March, there was a column describing reader suggestions for euthanasia for people unable to afford care, which would be on an involuntary basis for people who want to live.[21]

* Margaret Dore is an attorney in Washington State where assisted suicide is legal.  She is also President of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide.  For more information, see www.margaretdore.com and www.choiceillusion.org 

[1]  Compare: American Medical Association, Code of Medical Ethics, Opinion 2.211, available at http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion2211.page
[2]  The Oregon and Washington laws are similar.  For a short article about Washington’s law, see Margaret K. Dore, "'Death with Dignity': What Do We Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009, available at https://www.kcba.org/newsevents/barbulletin/BView.aspx?Month=05&Year=2009&AID=article5.htm
[3]  Id.
[4]  http://epcdocuments.files.wordpress.com/2011/10/attempts_to_legalize_001.pdf
[5]  See ORS 127.800 s.1.01(12) and RCW 70.245.010(13).
[6]  See e.g., Nina Shapiro, "Terminal Uncertainty: Washington’s new "Death With Dignity" law allows doctors to help people commit suicide—once they’ve determined that the patient has only six months to live. But what if they’re wrong?," 01/14/09, available at http://www.seattleweekly.com/2009-01-14/news/terminal-uncertainty 
[7]  See Jeanette Hall, Letter to the editor, "She pushed for legal right to die, and - thankfully - was rebuffed, Boston Globe, October 4, 2011 ("I am so happy to be alive!), available at http://www.boston.com/bostonglobe/editorial_opinion/letters/articles/2011/10/04/she_pushed_for_legal_right_to_die_and___thankfully___was_rebuffed/ Kenneth Stevens MD, Letter to the Editor, "Oregon mistake costs lives," The Advocate, the official publication of the Idaho State Bar, Sept. 2010, (scroll down to last letter at www.margaretdore.com/info/Stevens.pdf ).
[8]  Id.
[9]  Per her telephone call today.
[10]  The Oregon and Washington Acts can be viewed in their entirety here and here.
[11]  Id.
[12]  See Susan Donaldson James, "Death Drugs Cause Uproar in Oregon," ABC News, August 6, 2008, at http://abcnews.go.com/Health/story?id=5517492&page=1; "Letter noting assisted suicide raises questions," KATU TV, July 30, 2008, at http://www.katu.com/news/specialreports/26119539.html ; and Ken Stevens, MD, Letter to Editor, "Oregon mistake costs lives," The Advocate, the official publication of the Idaho State Bar, September 2011, to view, scroll down to bottom of second page here: http://www.margaretdore.com/info/September_Letters.pdf
[13] Id.
[14] Id.
[15] KATU TV at note 12
[16] ABC News at note 12
[17]  See also Affidavit of Ken Stevens MD (Leblanc v. Canada), with attachments, available at http://maasdocuments.files.wordpress.com/2012/09/signed-stevens-aff-9-18-12.pdf 
[18]  See "Suicides in Oregon: Trends and Risk Factors," Oregon Department of Human Services, Public Health Division, September 2010, page 6, ("Deaths relating to the death with Dignity Act (physician-assisted suicides) are not classified as suicides by Oregon law and therefore excluded from this report"), available at http://epcdocuments.files.wordpress.com/2011/10/or_suicide_report_001.pdf
See also Oregon Health Authority, News Release, "Rising suicide rate in Oregon reaches higher than national average," September 9, 2010, ("suicide rates have been increasing significantly since 2000") available at http://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf[19]  Cindy Uken, "State of Dispair: High-Country Crisis, Montana’s suicide rate leads the nation," Billings Gazetter, November 25, 2012, http://billingsgazette.com/news/state-and-regional/montana/montana-s-suicide-rate-leads-the-nation/article_b7b6f110-3e5c-5425-b7f6-792cc666008d.html?print=true&cid=print
[20]  See Brian Faller, "Perhaps it's time to expand Washington's Death with Dignity Act, The Olympian, November 16, 2011, available at http://www.theolympian.com/2011/11/16/1878667/perhaps-its-time-to-expand-washingtons.html
[21]  See Jerry Large, "Planning for old age at a premium," The Seattle Times, March 8, 2012 at http://seattletimes.nwsource.com/text/2017693023.html ("After Monday's column, some readers were unsympathetic, a few suggested that if you couldn't save enough money to see you through your old age, you shouldn't expect society to bail you out. At least a couple mentioned euthanasia as a solution.")

Assisted Suicide & Cross Aisle Alliances

http://helenair.com/news/state-and-regional/legislature-again-prepare-to-debate-divisive-ideas/article_98e87a62-80a8-585a-a641-6518acab5556.html?print=true&cid=print

Physician-assisted suicide promises to create lively debate, and "occasional cross-aisle allegiances."

23 hours ago  •  Associated Press

 

Republican legislative leaders and Democratic Gov. Steve Bullock are all saying they want to get along this session _ plans that could be tested by a long list of controversial issues.

The House and Senate leaders say their focus will be on core issues like spurring more natural resource development and revamping education funding. They are urging members of the majority caucus to bring forward solutions that matter to Montanans _ and can get the signature of a Democratic governor.

"I am hoping that we can dedicate ourselves on focusing on issues that matter to the people of Montana," incoming Senate President Jeff Essmann, a Billings businessman, said in a recent interview.

His counterpart in the House, Somers restaurant owner Mark Blasdel, said he wants substantive action and not fiery rhetoric.

"Assisted suicide in Washington and Oregon is a recipe for elder abuse and cloaked in secrecy"

http://missoulian.com/news/opinion/mailbag/oregon-washington-assisted-suicide-laws-include-no-protections-for-patients/article_074c4378-507b-11e2-8348-001a4bcf887a.html

By, Margaret Dore, Esq.

 

Supporting documentation follows letter, below.

I disagree with Susan Hancock’s description of how the Washington and Oregon assisted suicide laws work.   (Dec. 20, guest column)  I disagree that assisted suicide cannot be forced upon an unwilling person.

The Oregon and Washington assisted suicide acts have a formal application process. The acts allow an heir, who will benefit from the patient’s death, to actively participate in this process.

Once the lethal dose is issued by the pharmacy, there is no oversight. For example, there is no witness required at the death. Without disinterested witnesses, the opportunity is created for an heir, or for another person who will benefit from the patient’s death, to administer the lethal dose to the patient without his consent. One method would be by injection when the patient is sleeping. The drugs used in Oregon and Washington are water soluble and therefore injectable. If the patient woke up and struggled, who would know?

The Washington and Oregon acts require the state health departments to collect statistical information for the purpose of annual reports. According to these reports, users of assisted-suicide are overwhelmingly white and generally well-educated. Many have private insurance. Most are age 65 and older. Typically persons with these attributes are seniors with money, which would be the middle class and above, a group disproportionately at risk of financial abuse and exploitation.

The forms used to collect the statistical information do not ask about abuse. Moreover, not even law enforcement is allowed to access information about a particular case. Alicia Parkman a mortality research analyst at the Center for Health Statistics, Oregon Health Authority, wrote me: “We have been contacted by law enforcement and legal representatives in the past, but have not provided identifying information of any type.“

Assisted suicide in Washington and Oregon is a recipe for elder abuse and cloaked in secrecy. Don’t make our mistake.

Supporting documentation below.

Margaret Dore, Esq.

Seattle, Wash.

MAAS files New Lawsuit Against Board

On Monday, December 17, 2012, MAAS filed a new lawsuit against the Montana Board of Medical Examiners.

The lawsuit is a response to the Board's order entered on November 16, 2012 refusing to vacate Position Statement No. 20.   The lawsuit's claims include that the statement is invalid because it was adopted "without statutory authorization, . . . outside the Board's subject matter jurisdiction and/or because it is an infringement on the role of the Legislature." 

The petition for the lawsuit can be viewed by clicking here.  The attachments to that petition can be viewed by clicking here and here.

"Compassion & Choices is a successor organization to the Hemlock Society"

http://helenair.com/news/opinion/readers_alley/assisted-suicide-law-could-lead-to-patient-mistreatment/article_32bac11c-4985-11e2-9338-0019bb2963f4.html?print=true&cid=print

12/19/12

Theresa Schrempp Seattle, Wash.

I am a lawyer in Washington State where assisted-suicide is legal. 

Your readers should know that Compassion & Choices is a successor organization to the Hemlock Society, originally formed by Derek Humphry. In 2011, Humphry was the keynote speaker at Compassion & Choices’ annual meeting here in Washington State. In 2011, he was also in the news as a promoter of mail-order suicide kits from a company now shut down by the FBI. This was after a 29 year old man used one of the kits to commit suicide.

In 2007, Compassion & Choices was a plaintiff in Montana’s assisted-suicide case. Compassion & Choices requested legalization of assisted-suicide for “terminally ill adult patients.” The definition of this phrase was broad enough to include an otherwise healthy 18 year old who is insulin dependent or a young adult with stable HIV/AIDS. Such persons can live for decades with appropriate medical treatment.

Once someone is labeled “terminal,” an easy justification can be made that their treatment should be denied in favor of someone more deserving. Those who believe that legalizing assisted-suicide will promote free choice may discover that it does anything but.

Supporting authority not included in the published letter, below:

1.  This is a link to Compassion & Choices' newsletter announcing that Humphry would be the keynote speaker at its annual meeting in Washington State on October 22, 2012:  http://choiceisanillusion.files.wordpress.com/2011/10/derek.pdf

2.  This is an excerpt from Oregon's Register-Guard newspaper:

"A spotlight was cast on the mail-order suicide kit business after a 29-year-old Eugene man committed suicide in December using a helium hood kit.  The Register-Guard traced the $60 kit to [the company, which] has no website and does no advertising; clients find [the] address through the writings of Humphry."

http://projects.registerguard.com/web/newslocalnews/26910049-46/kit-police-suicide-fbi-springfield.html.csp

3.  Here is a link to my opinion letter with Richard Wonderly MD  analyzing Compassion & Choices' definition of "terminally ill adult patient." http://choiceisanillusion.files.wordpress.com/2012/07/schrempp_wonderly_opn_ltr1.pdf

Time to strengthen assisted suicide law

http://helenair.com/news/opinion/readers_alley/time-to-strengthen-assisted-suicide-law/article_b8257dd0-45be-11e2-b96a-0019bb2963f4.html

December 13, 2012, Independent Record

I have several concerns about the practice of assisted suicide, which has been rejected by most states and is currently legal in only two states (Washington and Oregon). 1) The potential for elder abuse is very real. Patients in Oregon with a “terminally ill” diagnosis have been refused treatment and steered toward assisted suicide. Patients can be pressured by a relative, who can even administer the dose. 2) A “terminally ill” diagnosis can be wrong. Some patients recover with treatment and may live a long time. 3) Montana already has a high suicide rate and state policy is directed at lowering that rate. The suicide rate in Oregon has increased since their law was passed.

Please tell your legislators to clarify and strengthen our law against assisted suicide.

Ruth Plesner
Victor

Liberal Massachusetts Defeated Assisted Suicide

http://www.lowellsun.com/todaysheadlines/ci_22157064/support-withered-assisted-suicide-ballot-question#ixzz2Egbgwy23

Support withered for assisted-suicide question

By Chris Camire

In late September, polls showed a ballot initiative that would make physician-assisted suicide legal for terminally ill patients had support from 68 percent of Massachusetts voters.

Over the next month, that support steadily eroded, and on Election Day the measure failed by a razor-thin 51-49 percent margin.

How did a proposal that seemed sure to pass just five weeks before the election come up short?

Joseph Baerlein, president of Rasky Baerlein Strategic Communications, who handled public relations for the Committee Against Physician Assisted Suicide, said the measure's opponents had to convince voters who supported the idea of assisted suicide that the bill before them was flawed.

"We focused our campaign strategy on looking at those weaknesses," said Baerlein.

“Dr. Stevens, you saved my life!”

http://missoulian.com/news/opinion/mailbag/doctor-helped-patient-with-cancer-choose-life-over-assisted-suicide/article_63e092dc-37e5-11e2-ae61-001a4bcf887a.html?print=true&cid=print

 

Doctor helped patient with cancer choose life over assisted suicide

 

November 27, 2012 6:15

 

I am a doctor in Oregon, one of two states where assisted suicide is legal. This letter responds to your article about the controversy over this practice in Montana. (AP article re: Medical Examiners Board, Nov. 16). I write to clarify that legalizing assisted suicide would allow non-dying persons to be steered to suicide.

Oregon’s assisted-suicide law applies to patients predicted to have less than six months to live. In 2000, I had a cancer patient named Jeanette Hall. Another doctor had given her a terminal diagnosis of six months to a year to live. This was based on her not being treated for cancer.

At our first meeting, Jeanette told me that she did not want to be treated, and that she wanted to opt for what our law allowed – to kill herself with a lethal dose of barbiturates.

I did not and do not believe in assisted suicide. I informed her that her cancer was treatable and that her prospects were good. But she wanted “the pills.” She had made up her mind, but she continued to see me.

On the third or fourth visit, I asked her about her family and learned that she had a son. I asked her how he would feel if she went through with her plan. Shortly after that, she agreed to be treated, and her cancer was cured.

Five years later she saw me in a restaurant and said, “Dr. Stevens, you saved my life!”

For her, the mere presence of legal assisted suicide had steered her to suicide.

I understand that assisted suicide will be an issue in your upcoming legislative session. I urge you to encourage your legislators to clarify your law to keep assisted suicide out of Montana.

Kenneth Stevens,
Sherwood, Oregon

Assisted suicide leaves no room for doctors' errors or erroneous prognostications

 http://ravallirepublic.com/news/opinion/mailbag/article_91d0a4cc-c434-5a41-9459-c808bf523634.html

 

Jeanette Hall's letter ( "Assisted suicide prompts some terminally ill patients to give up on life prematurely"), about how she would have died from assisted suicide if her doctor hadn't talked her out of it, hit a nerve. Her stated motivation was that she had been diagnosed with cancer and given six months to a year to live. That was 12 years ago.

 

Doctors do not know the future. They are often wrong. Indeed, this has happened twice in my family.

 

The first time was with my father. At age 66, he collapsed as he was leaving a doctor's appointment in the hospital at Glasgow. A week or so later his doctor recommended that we "pull the plug." I instead moved my father to another hospital. He fully recovered and lived nine more years. The doctor was wrong.

 

The second time was with me. When I was 62 years old, I was paralyzed due to a disease and put on a respirator. After four months, my doctors offered to take me off the respirator. They said that there was no chance of recovery. They said that if I lived, I would always be respirator dependent and a quadriplegic. Instead, I eventually lost my paralysis and even went back to work. My doctors, excellent doctors with years of experience, were wrong. It is now 14 years later.

 

Proponents of assisted suicide sometimes claim that assisted suicide is no different than pulling the plug. This is untrue. When you pull the plug, the patient doesn't necessarily die. If the patient does die, he or she dies due to his or her illness, not a lethal overdose.

 

I hope that we can keep assisted suicide out of Montana.

 

Jerry and Dora Lou Jacobson,

Glasgow

 

Assisted suicide: Idea is repugnant

http://missoulian.com/news/opinion/mailbag/assisted-suicide-idea-is-repugnant/article_f498f69c-407e-11e2-afae-001a4bcf887a.html

I was glad to see the letter in your publication by Brad Williams  (Nov. 28). Assisted suicide is an important topic for Montana, where proponents are wrongly claiming that the practice is legal and the majority of the population are senior citizens (over 50 years of age).

I retired from the Motion Picture Pension and Health Plans in Studio City, Calif., as the chief financial officer. One reason that I retired to Montana was that I had the perception that it was senior-citizen friendly, i.e., unlike Oregon and Washington, which have adopted laws allowing doctors and family members to assist people in killing themselves. That was repugnant to me.

The proposed legalization is for terminally ill persons. "Terminally ill" is a term that I am all too familiar with. In my previous employment, one would need to be terminally ill to qualify for a pension if they had not reached a specified age. Many, many times doctors deemed someone terminally ill and they wound up outliving their caregivers; not really, but they lived many years. If these persons had instead been applying for a lethal dose and used it, they would have been dead before their time.

Ted Friesen, Bigfork